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PTRS 746 Exam 1 > Hip Fracture > Flashcards

Hip Fracture Flashcards

1
Q

Q: What is the approx. incidence of hip fractures per year?

A

329,000`

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2
Q

Q: What percent of hip fractures occur in women?

A

76

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3
Q

Q: 1 in ____ individuals die within 1 year of a hip fracture.

A

5

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4
Q

Q: 1 in _____ require nursing home care for at least 1 year.

A

4

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5
Q

Q: What percent of hip fractures result from falls?

A

90

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6
Q

Q: The risk of fracture ____________ every 5 years after the age of 50.

A

doubles

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7
Q

Q: The fracture rate of institutionalized individuals is _____x greater than those in the community.

A

5-11

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8
Q

Q: ________% of survivors fail to recover to prior functional status within 1 year of injury.

A

26-75

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9
Q

Q: Presence of a comorbidity increases mortality by ~____%.

A

16

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10
Q

Content: Intracapsular Hip Fracture (2)

A
  1. Involve femoral head or neck
  2. Higher rate of non-union and AVN
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11
Q

Content: 3 types of intracapsular fractures

A
  1. Subcapital 2. Transcervical 3. Basicervical
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12
Q

Content: Extracapsular Hip Fracture (2)

A
  1. Involve trochanteric region
  2. Types trochanteric, intertrochanteric, subtrochanteric
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13
Q

Content: 4 Stages of the Garden Staging System

A

1 = incomplete, may be impacted

2 = complete, non-displaced

3 = complete, partially displaced

4 = complete, fully displaced

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14
Q

Q: Which stages of the Garden Staging System require surgery?

A

2-4, however, by the time we see them all the stages will look the same to us

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15
Q

Q: What are the steps in fracture management and which step involves PTs?

A

Steps: reduction, fixation, restoration of function PT = restoration of function

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16
Q

Content: 4 goals of fracture management

A
  1. Pain control
  2. Reduction and fixation in good position
  3. Return to function
  4. Prevent complications
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17
Q

Content: 3 indications for a conservative treatment plan for fracture management

A
  1. Unstable medical status
  2. Non-displaced fractures
  3. Risk of surgery vs. risk of immobility
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18
Q

Content: 3 Surgical treatments for hip fracture

A
  1. ORIF
  2. HA
  3. THA
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19
Q

Q: What 4 factors should be considered when hip surgery is an option?

A
  1. Age
  2. Mobility status
  3. Mental state
  4. Pre-existing bone and joint pathology
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20
Q

Q: ORIF or pinning is thought as _______ ___________.

A

bone conserving

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21
Q

Q: What is the failure rate of ORIF?

A

20-36%

22
Q

Q: What population is ORIF suggested for?

A

Younger, highly active pts

23
Q

Q: ORIF is the treatment of choice for _______________ fracture.

A

Extracapsular

24
Q

Q: Hemiarthroplasty is considered for ______________ fracture.

A

Intracapsular

25
Q

T/F: ORIF appears to have better outcomes than HA.

A

False, flip it

26
Q

Q: What is the failure rate of HA?

A

6-18%

27
Q

Q: What is the risk of dislocation with HA?

A

~5%

28
Q

Q: With HA you see a deterioration of function after ______ years

A

3-5

29
Q

T/F: With HA only the femoral component is replaced.

A

True

30
Q

Term: Femoral head articulates with acetabulum, but is fixed to the stem

A

Unipolar

31
Q

Term: Femoral head articulates with both acetabulum and stem

A

Bipolar

32
Q

T/F: Bipolar replacements are better than unipolar replacements.

A

False, no evidence that one is better than the other

33
Q

T/F: It is unclear whether cemented or uncemented is the superior approach.

A

True

34
Q

Q: THA is considered for _______________ fracture

A

intracapsular

35
Q

T/F: THA has better outcomes than HA beyond 3 years.

A

True

36
Q

Q: What is the risk of dislocation for a THA?

A

5-10%

37
Q

T/F: THA is never used to revise a failed ORIF or HA.

A

False, often

38
Q

Content: Posterior THA precautions (3)

A
  1. No ADD past neutral
  2. No flexion past 90
  3. No IR
39
Q

Content: Anterior THA precautions (3)

A
  1. No ABD
  2. No (excessive) extension
  3. No ER
40
Q

Q: What are the 3 risks associated with posterior THAs?

A
  1. Dislocation
  2. Infection
  3. DVT
41
Q

Q: What are the 3 risks associated with anterior THAs?

A
  1. Increased operative time
  2. Increased blood loss
  3. Infection
42
Q

Content: Complications of hip surgery (8)

A
  1. CV
  2. Pneumonia
  3. Pressure ulcers
  4. Delirium
  5. UTI
  6. Wound infection
  7. Depression
  8. Malnutrition
43
Q

Q: What is the single best predictor of operative mortality following hip fracture?

A

Delirium

44
Q

Q: Acute delirium occurs in _________% of post-op pts.

A

30-50

45
Q

Q: Delirium is usually observed within POD _____, resolved by POD ___.

A

1-5, 7

46
Q

Content: DVT (3)

A
  1. Very common complication of hip fracture
  2. Incidence of up to 60% w/o prophylaxis
  3. Incidence of 20-30% w/prophylaxis
47
Q

Content: PE (3)

A
  1. Incidence ~10-15%
  2. Mortality ~2-10%
  3. Account for 14% of deaths due to hip fracture
48
Q

Q: What is the key to rehab for hip fractures?

A

Early mobilization

49
Q

Q: Delayed mobilizaiton is associated with… (5)

A
  1. Delirium
  2. Pneumonia
  3. Increased length of stay
  4. Greater 6 mo. mortality
  5. Poorer 2 mo functional performance
50
Q

T/F: The vast majority (90%) of hip fractures occur due to trauma.

A

False: falls

51
Q

T/F: Falls are the leading cause of death in individuals greater than 65 years old.

A

True

52
Q

Diagram: Risk factors for falls

A

PTRS 746 Exam 1 (9 decks)

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